Division of Cardiology, Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea.
Department of Statistics and Actuarial Science, Soongsil University, Seoul, Korea.
J Allergy Clin Immunol Pract. 2021 Feb;9(2):872-880.e4. doi: 10.1016/j.jaip.2020.09.008. Epub 2020 Sep 19.
Allergic rhinitis (AR), atopic dermatitis (AD), and asthma, each by itself, are known to be associated with a higher risk of cardiovascular disease. Each of these diseases often coexists with one another, but the effect of combined allergic diseases on the long-term risk of myocardial infarction (MI) and mortality remains unknown.
To evaluate the effects of various combinations of the allergic triad on the risk of MI and mortality.
Adult allergic disease patients without prior MI were enrolled from the nationwide health check-up data provided by the Korean National Health Insurance Service in 2009. The primary and secondary end points were all-cause death and MI.
A total of 9,548,939 individuals older than 20 years were selected for analysis. The prevalence of allergic diseases was 13.9% for AR, 0.4% for AD, and 2.7% for asthma. During a median 8.2 years of follow-up, 105,659 MIs and 298,769 deaths occurred. All allergic diseases were associated with an increased risk of MI (AR, adjusted hazard ratio [HR], 1.11, 95% CI, 1.10-1.13; AD, HR, 1.14, 95% CI, 1.06-1.24; asthma, HR, 1.37, 95% CI, 1.33-1.40), whereas mortality risk was increased only for patients with AD (HR, 1.15; 95% CI, 1.10-1.20) or asthma (HR, 1.41; 95% CI, 1.39-1.43). Among the combinations of allergic diseases, patients with both AD and asthma had the highest risk of mortality (HR, 1.71; 95% CI, 1.46-2.00) and MI (HR, 1.57; 95% CI, 1.15-2.16). The results were significant after adjusting for demographic characteristics, comorbidities, socioeconomic status, and lifestyle factors.
Patients with both AD and asthma have the highest risk of MI and mortality among all allergic disease combinations. Physicians should evaluate combinations of allergic conditions in allergic disease patients and promptly assess and manage their future risk of MI and mortality.
过敏性鼻炎（AR）、特应性皮炎（AD）和哮喘本身就与心血管疾病风险增加有关。这些疾病通常彼此共存，但联合过敏性疾病对心肌梗死（MI）和死亡率的长期风险的影响尚不清楚。
评估过敏三联症的各种组合对 MI 和死亡率的影响。
2009 年，从韩国国家健康保险服务提供的全国健康检查数据中招募了没有先前 MI 的成年过敏疾病患者。主要和次要终点是全因死亡和 MI。
共选择了 9548939 名年龄在 20 岁以上的个体进行分析。AR 的患病率为 13.9%，AD 为 0.4%，哮喘为 2.7%。在中位数为 8.2 年的随访期间，发生了 105659 例 MI 和 298769 例死亡。所有过敏性疾病均与 MI 风险增加相关（AR，调整后的危险比[HR]，1.11，95%CI，1.10-1.13；AD，HR，1.14，95%CI，1.06-1.24；哮喘，HR，1.37，95%CI，1.33-1.40），而死亡率风险仅增加 AD（HR，1.15；95%CI，1.10-1.20）或哮喘（HR，1.41；95%CI，1.39-1.43）患者。在过敏性疾病的组合中，同时患有 AD 和哮喘的患者的死亡率（HR，1.71；95%CI，1.46-2.00）和 MI（HR，1.57；95%CI，1.15-2.16）风险最高。在调整人口统计学特征、合并症、社会经济地位和生活方式因素后，结果仍然显著。
在所有过敏疾病组合中，同时患有 AD 和哮喘的患者发生 MI 和死亡率的风险最高。医生应该评估过敏患者的过敏情况组合，并及时评估和管理他们未来的 MI 和死亡率风险。
